PROJECT SUMMARY/ABSTRACT - RightSteps This Phase I SBIR application responds to PA-18-574. The Right Steps: A Virtual Reality Application/ Intervention to Improve Wayfinding in Mild Cognitive Impairment (RightSteps) will create a virtual reality clinical training environment to deliver virtual wayfinding scenarios and a companion mobile phone application for real world rehearsal to assist in targeting wayfinding skill building in patients with mild cognitive impairments to enhance functional independence. RightSteps applies technology as a creative but practical solution to target improvements in daily life experiences of individuals with cognitive disability. Specifically focusing on mild cognitive impairment/early dementia patient, RightSteps is aligned with NIA?s research priority for the ?development of programs to support cognitive training to improve cognitive function in elderly?.[including] novel, engaging computer-based cognitive-training programs based on empirically-established approaches using cognitive training to target a specific neural system/functional domain.? As loss of functional independence defines the transition from MCI to dementia, interventions such as RightSteps have the potential to slow clinical, and potentially even neuropathological, progression. RightSteps is designed in a manner agnostic to mobility demands, and thus can be utilized by patients with both physical as well as non-physical impairments. The team of Emory University researcher Dr. Stringer and development company Virtually Better, Inc., will develop a VR prototype to enhance route recall training, leveraging empirically-validated EON Mem mnemonic strategies. Patients will be able to train in use of wayfinding/route recall strategies using virtual environment scenarios of the same clinical setting that approximates real world wayfinding and be able to practice at home using a companion mobile app. By closely approximating and enhancing the real clinical setting, strategy training may be more likely to generalize to patients? everyday environment to increase patient functional independence. If successful in Phase I, this project will lead directly to a Phase II clinical trial to test the efficacy of the RightSteps VR Program and App in preserving functional independence and improving wayfinding in individuals with MCI/early dementia (ED). The aims of this 12-month Phase I project include the development of the RightSteps prototype that will deliver virtual environments and scenarios for training and rehearsal of wayfinding clinical intervention with a supportive mobile application for home-based rehearsal and skill-building. Our specific aims include: Aim 1: Iterative development of the RightSteps prototype to deliver virtual wayfinding scenarios, based on an indoor path patients will traverse, for the VR clinical training environment and a mobile-phone based application for real world rehearsal. Aim 2: Assess the usability, acceptability, and realism (compared to the actual indoor path) of RightSteps via a focus group composed of MCI/ED patients and their caregivers using quantitative and qualitative measures. Aim 3: Optimization of the RightSteps prototype based on feedback from focus group and comparative assessment with the same focus group participants.